Vestibular system graphic


Harvard Medical School Department of Otolaryngology

More than half of the population will see a doctor at some point in their lives with symptoms related to the vestibular system (e.g., dizziness, vertigo, imbalance, blurred vision). Vestibular disorders are often debilitating and even life-threatening when falls result. Researchers focusing in the area of the vestibular system seek to improve diagnostic techniques and to develop and refine treatments for patients suffering from related disorders.

Collaboration between our scientists, engineers, and physicians has led to the development of balance aids for patients suffering imbalance, as well as vestibular implants for patients who have lost inner ear function. Additionally, researchers are dedicated to overcoming the limitations of clinical vestibular testing and improving diagnoses for the large number of patients whose diagnoses cannot be confirmed by testing.

The work of our vestibular researchers largely takes place in our vestibular laboratories:

Jenks Vestibular Physiology Laboratory

Under the leadership of Richard F. Lewis, MD, and Faisal Karmali, PhD, scientists in the Jenks Vestibular Physiology Laboratory study vestibular function using various behavioral measures, including assays of balance, perception, and the vestibulo-ocular reflex (VOR). They engage in both basic science and translational research, using dynamic system models to help gain insight into the complexities of multi-sensory integration involved in our sense of spatial orientation.

The Jenks Vestibular Physiology Laboratory was the first to study vestibular implants that treat patients suffering from severe bilateral vestibular loss. Investigators also have a number of patents that have been licensed by commercial entities intent on bringing this device to the market in the near future. They continue to maintain significant research interests in this area.

Presently, much of the translational effort focuses on the development of more sensitive and more specific diagnostic tests of vestibular function for patients suffering from dizziness, imbalance, or vertigo. This is significant because a substantial fraction of patients suffering from these conditions are difficult to diagnose using existing tests that focus on measurements of reflexive responses such as the vestibulo-ocular reflex (VOR).

Much of the basic science efforts focus on human spatial orientation and perception, with a strong interest in understanding the limits of human performance via the measurement of thresholds. We also perform basic science studies focusing on understanding how the brain combines cues from many different sensory systems (sometimes referred to as multi-sensory integration), with a keen interest in how the brain processes ambiguous sensory cues, such as those provided by the otolith organs that provide both gravitational and acceleration cues.

Jenks Vestibular Physiology Laboratory Investigators


Jenks Vestibular Diagnostic Laboratory

Also under the direction of Richard F. Lewis, MD, the Jenks Vestibular Diagnostic Laboratory offers a proprietary approach to clinical vestibular testing to assess vestibular function in the inner ear. There are four main tests offered in the laboratory, including electonystagmogram (ENG), rotary chair testing, visual-vestibular interaction, and posturography (EquiTest). Head impulse testing and treatment for mal de debarquement (MdDS) are also offered.

In addition to its clinical vestibular testing role, the laboratory’s research objectives include ways of optimizing vestibular test data using machine learning and multivariate statistics in order to make more accurate clinical diagnoses.